OSTDS Forms

DOH-Charlotte Forms 

Application for Abandonment Permit (crush/fill septic tank) (112 KB PDF)

Application for Construction Permit (new system, repair, existing, modification) (81 KB PDF)

Business Survey (for operating permit) (55 KB PDF)

Deed Notice for PBTS systems (182 KB PDF)

Letter of Authorization for new/repair system applications (69 KB PDF)

Operating Permit Application (77 KB PDF)

Utility Easement Agreement for Duplexes (68 KB PDF)

Variance Application  (74 KB PDF)

All Other OSTDS Forms 

DH 4012, Application for Septage Disposal Service Permit, Temporary System Service Permit, Septage Treatment and Disposal Facility, Septic Tank Manufacturing Approval (01/92) (22 KB; pdf)

DH 4012A, Agricultural Use Plan (08/09) (62 KB; pdf)

DH 4014, Septic Tank Cleaning Service and Temporary Privy Service Inspection Report (06/98) (16 KB; pdf)

DH 4015 (page 1), Application for Onsite Sewage Treatment and Disposal System Construction Permit - Application (08/09) (35 KB; pdf)

DH 4015 (page 1) pdf form (670 KB; pdf)

DH 4015 (page 2), Application for Onsite Sewage Treatment and Disposal System Construction Permit - Site Plan (08/09) (37 KB; pdf)

Site Plan Instructions (23 KB; pdf)

DH 4015 (page 3), Site Evaluation and System Specifications (08/09) (32 KB; pdf)

DH 4015 (page 3) pdf form (120 KB; pdf)

DH 4015 (page 4), Existing System and System Repair Evaluation(08/09) (37 KB; pdf)

DH 4015 (page 4) pdf form (140 KB; pdf)

DH 4016 (page 1), Construction Permit (08/09) (32 KB; pdf)

DH 4016 (page 3), System Repair Certification (08/09) (31 KB; pdf)

DH 4016 (page 3) pdf form (110 KB; pdf)

DH 4066, Application for Maintenance Service Permit (02/10) (11 KB; pdf)

DH 4081, Application for Onsite Sewage Treatment and Disposal System Operating Permit (includes DH 4081A, Assessment of Waste Handling and Business Activities) (10/96) (26 KB; pdf)